RESUMEN
The authors demonstrate the HCV nucleic acid amplification method is not wide-spread in Hungary yet. The HCV-RNA is usually detectable 2-4 weeks after infection independently the immunostate of the patients. The authors help to select the adequate measurement(s) in logical order when HCV infection is suspected. The benefit of the PCR method is emphasized. Monitoring of the HCV-RNA titer of the liver transplanted patients promotes to establish the fluctuation of HCV-RNA copies and the effectivity of therapy following transplantation. The detection of HCV-RNA by PCR method is a proof of an acute or chronic infection and rules out past infection. The quantitative PCR measurement is useful for determination of indication and control of efficacy of antiviral therapy.
Asunto(s)
Hepacivirus/genética , Hepacivirus/aislamiento & purificación , Hepatitis C/diagnóstico , Trasplante de Hígado/efectos adversos , Reacción en Cadena de la Polimerasa/métodos , ARN Viral/aislamiento & purificación , Adulto , Femenino , Hepatitis C/etiología , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
A case of orthotopic liver transplantation (OLT) for secondary Neuroendocrine Tumor (NET), whose primary site was not detected at the time of surgery, is reported. The primary pancreatic lesion was found 20 months later in association with recurrence of neoplasm in the graft and with a paraneoplastic syndrome peculiar of glucagonoma. The patient started octreoide therapy with a decrease of the glucagone level but without reduction of the tumor size, nor disappearance of the clinical syndrome. A few months later the primary lesion was surgically removed, but her general condition deteriorated and the patient died waiting for liver retransplantation. A discussion about the management and the diagnostic tools for preoperative staging of these neoplasms and their ability to identify the primitive and secondary location of neuroendocrine tumors is presented.
Asunto(s)
Neoplasias Hepáticas/secundario , Trasplante de Hígado , Tumores Neuroendocrinos/patología , Neoplasias Pancreáticas/patología , Adulto , Resultado Fatal , Femenino , Humanos , Neoplasias Hepáticas/cirugía , Tumores Neuroendocrinos/cirugía , Pancreatectomía , Neoplasias Pancreáticas/cirugíaRESUMEN
The authors report in this ciency in the majority of the cases was alcohol abuse or article about their experiences, how could they select a small group of patients awaiting liver transplantation since September 1994. The cause of the liver insuffiHCV infection. During 37 weeks 3 liver transplantations were performed and 5 patients died on the waiting list. (15,6% of the patients on the waiting list.)
Asunto(s)
Hepatopatías/mortalidad , Trasplante de Hígado , Adulto , Anciano , Femenino , Humanos , Hungría , Hepatopatías/cirugía , Masculino , Persona de Mediana Edad , Organización y Administración , Resultado del Tratamiento , Listas de EsperaRESUMEN
We report two cases of Kaposi's sarcoma in recipients of solid organ transplants, presenting (Case 1) 12 months after liver transplantation and (Case 2) 7 months after kidney transplantation. Both patients share the following features: natives from the Mediterranean area (Southern Italy), multiple immunosuppressive regimen, infection with hepatitis B and cytomegalovirus. During the 3 yr of follow-up after the diagnosis, their immunosuppressive regimen was reduced and they were treated with alpha interferon with remission of the clinical findings. The management of Kaposi's sarcoma in organ transplant recipients remains a controversial issue because of the risks of organ rejection associated with the reduction of immunosuppression and with the use of interferon.